Adaptation of Kirkpatrick's model to evaluate simulation-based education in nursing students: A quasi-experimental study

Background: Simulation-based education (SBE) is a commonly utilized teaching strategy in nursing education.However, a systematic and empirical methodology is required to thoroughly evaluate its impact.Objective: This study aimed to evaluate the effectiveness of simulation-based education in improving nursing students' clinical reasoning skills by adapting Kirkpatrick's model.Methods: This quasi-experimental study recruited 143 nursing students through purposive sampling to participate in SBE.Data were collected at baseline (pretest), immediately following the intervention (posttest 1), and 10 weeks after the intervention (posttest 2) using the student satisfaction and selfconfidence in learning scale, acute asthmatic attack knowledge questionnaire, and clinical reasoning scale for nursing students.A one-sample t-test, paired t-test, and repeated measures ANOVA were employed to analyze the data.Results: Participants at the reaction level (Kirkpatrick's model level 1) showed a positive reaction with a mean score of 4.2378 (SD = 0.54) for satisfaction and 4.18 (SD = 0.48) for self-confidence.In the learning level (Kirkpatrick's model level 2), participants showed a significant improvement in both knowledge (mean score: 5.52-7.79,p value = .00 0) and clinical reasoning skills (CRS) (mean score: 3.19-4.04,p value = .00 0) after the SBE.Likewise, in the behavior (Kirkpatrick's model level 3), a repeated measures ANOVA indicated that the CRS was statistically significant across the assessment stages: pretest, posttest 1, and posttest 2 (F = 203.73,p = .00 0, with a Partial Eta Squared of 0.589).Conclusion: An evaluation using Kirkpatrick's model showed that the SBE improves students' responses, learning, and behavior.It enhances students' knowledge and CRS for treating patients with acute asthmatic episodes and supports the retention of CRS for application in clinical practice.Overall, the model serves as an effective tool for evaluating SBE.